Koskderelioglu Asli, Gedizlioglu Muhtesem, Ceylan Yasin, Gunlusoy Bulent, Kahyaoglu Nilden
Department of Neurology, Izmir Bozyaka Education and Research Hospital, Saim Cikrikci Cad. No:59, Bozyaka/Karabaglar, 35170, Izmir, Turkey.
Department of Urology, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey.
Neurol Sci. 2017 Aug;38(8):1445-1451. doi: 10.1007/s10072-017-2989-3. Epub 2017 May 8.
Androgen deprivation is a therapeutic option for patients with prostate cancer (PC). However, it has negative effects on sleep quality and psychological condition. Here, we evaluated the appearance of sleep disturbances in patients on androgen deprivation therapy (ADT). We administered Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Epworth Sleepiness Scale (ESS), and Fatigue Severity Scale (FSS) to consecutive prostate cancer patients who had undergone radical prostatectomy and are presently either under adjuvant ADT or followed in an unmedicated program (non-ADT). The results of the tests in ADT and non-ADT groups in addition to the demographic data and the features of the malignancy were statistically compared. Of the 106 patients enrolled, 48 (45.3%) were receiving adjuvant ADT and 58 (54.7%) were not. Age, disease duration, and education levels showed no difference between the two groups. Compared with the non-ADT group, the patients receiving ADT showed higher levels of depression, worse quality of sleep, and more severe fatigue (p < 0.001, for each). There was no significant difference among the two groups regarding excessive daytime sleepiness (p = 0.856). The mean PSQI scores showed a positive correlation with BDI and FSS scores (r = 0.710, p < 0.001; r = 0.528, p < 0.001, respectively). Additionally, ADT was strongly associated with PSQI and FSS scores at multivariate analysis (p = 0.037, p = 0.043, respectively). We conclude that PC patients receiving ADT are likely to be fatigued, more depressed, and had poorer sleep quality. Our study showed that receiving ADT therapy is strongly associated with poor sleep quality and fatigue.
雄激素剥夺疗法是前列腺癌（PC）患者的一种治疗选择。然而，它对睡眠质量和心理状况有负面影响。在此，我们评估了接受雄激素剥夺疗法（ADT）的患者睡眠障碍的出现情况。我们对连续接受根治性前列腺切除术且目前正在接受辅助ADT或处于非药物治疗方案（非ADT）随访中的前列腺癌患者进行了匹兹堡睡眠质量指数（PSQI）、贝克抑郁量表（BDI）、爱泼华嗜睡量表（ESS）和疲劳严重程度量表（FSS）的评估。除人口统计学数据和恶性肿瘤特征外，还对ADT组和非ADT组的测试结果进行了统计学比较。在纳入的106例患者中，48例（45.3%）接受辅助ADT，58例（54.7%）未接受。两组在年龄、病程和教育水平方面无差异。与非ADT组相比，接受ADT的患者抑郁程度更高、睡眠质量更差、疲劳更严重（每项p<0.001）。两组在白天过度嗜睡方面无显著差异（p = 0.856）。PSQI平均得分与BDI和FSS得分呈正相关（r = 0.710，p<0.001；r = 0.528，p<0.001）。此外，在多变量分析中，ADT与PSQI和FSS得分密切相关（分别为p = 0.037，p = 0.043）。我们得出结论，接受ADT的PC患者可能更容易疲劳、抑郁程度更高且睡眠质量更差。我们的研究表明，接受ADT治疗与睡眠质量差和疲劳密切相关。
